Brian Davault, MD
Individual provider Active NPI Family Medicine Physician · Wabash, IN
NPI 1467946368 · NPPES record last updated Oct 11, 2022
Key facts
- NPI
- 1467946368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01082532A (IN)
- Practice address
- 8 John Kissinger Dr
Wabash, IN 46992-1648 - Phone
- (260) 563-7451
- Fax
- (260) 569-2284
- NPI assigned
- Jun 15, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Parkview Wabash Hospital Inc
Parkview Health System Inc
Practice addresses (Care Compare)
10 John Kissinger Dr
Wabash, IN 46992-1648
1104 N Wayne St
Parkview Wabash Health Clinic North Manch
North Manchester, IN 46962-1001
Phone 2609822102260569
3909 New Vision Dr
PPG First Care Walk in Clinic
Fort Wayne, IN 46845-1725
Phone (260) 469-6610
8 John Kissinger Dr
Wabash, IN 46992-1648
Phone (260) 563-7451
Hospital & facility affiliations
- Angels of Mercy Homecare
- Parkview Wabash Hospital, Inc
- Parkview Regional Medical Center
- Marion General Hospital
- Parkview Huntington Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210819000681 | IN | Practitioner - Family Practice | 6507112315 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01082532A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Family Medicine | Current |
Accepting new patients |
Locations
817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020
4402 E State Blvd
Fort Wayne, IN 46815
Phone (260) 425-5500
3909 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-8000
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
1104 N Wayne St
North Manchester, IN 46962
Phone (260) 982-2102
8 John Kissinger Dr
Wabash, IN 46992
Phone (260) 563-7421
Interoperability endpoints
- bdavault130111@direct.parkviewexchange.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01082532A | IN | Yes |
Addresses
Primary practice location
8 John Kissinger Dr
Wabash, IN 46992-1648
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other practice location 1
4402 E State Blvd
Fort Wayne, IN 46815-6917
Phone (260) 425-5500
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bdavault130111@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ |
Other providers in Wabash, IN
- Meghan Dee Culwell
- Christine Curless
- Eric E Dale
- Rachel Adele Dale
- Bridget M Darr
- Katie Davidson
- Erin Marie Davis
- Daywalt Pharmacies, Inc
- Sherise L.E. Deardorff
- Gary Degrandchamp
All providers in Wabash, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.